Medicaid spending on opioid treatment soars in Ohio, auditor reports

The Centers for Disease Control and Prevention released new numbers on the opioid crisis, saying the number of overdose visits to hospital emergency rooms soared last year, the latest evidence the nation's drug crisis is getting worse.
AP

The number of Ohio Medicaid recipients who have an opioid addiction has quadrupled since 2010, a state auditor's report shows.

Ohio Auditor Dave Yost also noted Tuesday the Medicaid system has seen an increase in medication-assisted treatment, which is the recommended treatment for opioid addiction. He called that "a positive direction."

It's also a big cost to taxpayers.

Epidemic has proven to be costly in Ohio

In 2010, the state’s cost of treating opioid addiction through medication-assisted therapies was more than $13 million, the report shows. It had jumped to $110 million by 2016.

“Despite the tragic number of deaths associated with opioid abuse, and the widespread publicity surrounding this epidemic, we continue to see more and more people falling prey to this insidious addiction,” Yost said in his released statement.

The number of unique individuals on Medicaid receiving medication-assisted treatment for addiction jumped from about 6,500 in 2010 to nearly 48,000 in 2016, according to the report.

“Medicaid is the safety net for our most-needy Ohioans,” Yost said. “That safety net is being stretched thin by the thousands of people who have lost their jobs, their health insurance and are in desperate need of care. As much as we’ve done in Ohio to curb this epidemic, more needs to be done.”

Awareness has made a difference

Dr. Shawn Ryan, founder of BrightView Health clinics and president of the Ohio chapter of the American Society of Addiction Medicine, said the report should not be a surprise.

The message to the public to get addiction treatment – and to get evidence-based treatment – has magnified over the years since the overdoses started pummeling the state, and the nation, he said.

That means the use of FDA-approved medications buprenorphine, methadone or injectable naltrexone (commonly known by its brand name, Vivitrol). It's the kind of treatment that addiction researchers have been urging people to use rather than abstinence-based treatment for opioid addiction.

“As much as we’ve done in Ohio to curb this epidemic, more needs to be done.”

Ohio auditor Dave Yost

Awareness has made a difference, Yost agreed.

Hospitals and primary care doctors are more likely now than even a few years ago to screen for opioid addiction. So they’re more likely to identify people in need.

“We weren’t looking before,” Ryan said.

“The number of people in need and the number of people identified both have gone up,” he explained.

Yost added that hospitals may have identified more people because of fentanyl and the fentanyl derivatives that have caused critical overdoses.

An increase in people with Medicaid

Also, in 2014, the Ohio Medicaid program was expanded to serve more people, which accounts for a portion of the increase.

In Licking County, there has been a 195 percent increase in the number of Medicaid members who have been diagnosed as opioid addicted or receiving medication assisted treatment.

The overall increase represents an increase from 8 people per 1,000 Medicaid recipients in 2010 to 11.2 in 2013. The number then jumped to 23.5 per 1,000 in 2016.

Kay Spergel, Executive Director for Mental Health and Recovery for Licking and Knox Counties, said the report's conclusions are not a surprise with the expansion.

"That access has made a large difference in people coming forward to engage in treatment," she said.

Spergel said with more people having access to treatment, including more single adults, the percentages of those who are battling addiction will be reported to be higher.

"There has been some positive movement in terms of getting people to recognize the issue and what is there to help them," she said. "It's a bittersweet thing. You think it's a significant number but if you think about the interventions and efforts to address this epidemic, at least we've begun to identify people to get them the services they need."

Ryan added that people with opioid addiction also may not seek help until their condition has progressed to a point where they lost a job or a lot of money.

Those covered by private insurance, he said, "often use 30-day abstinence-based residential treatment, which doesn't work" for most people with this kind of addiction.

Advocate reporter Bethany Bruner contributed to this report.

Quick Response Team available

If you or someone you know is battling opioid addiction or has overdosed and you are seeking help, call 211 to be connected with a member of the Quick Response Team. This team is able to provide connections to treatment and services in a non-judgmental environment.